Neonatal Alloimmune Thrombocytopenic Purpura

John E. Deaver; Phyllis C. Leppert; Charles G. Zaroulis

doi:10.1055/s-2007-999848

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 1986; 3(2): 127-131
DOI: 10.1055/s-2007-999848

ORIGINAL ARTICLE

Neonatal Alloimmune Thrombocytopenic Purpura

John E. Deaver¹ , Phyllis C. Leppert² , Charles G. Zaroulis³

¹Naval Hospital, Department of Obstetrics and Gynecology, Oak Harbor, Washington
²Department of Obstetrics and Gynecology, Division of Perinatology, Columbia University College of Physicians and Surgeons, New York, New York
³The Irving Geist Blood Bank and Polly Annenberg Levee Hematology Center, Mount Sinai School of Medicine, New York, New York

Abstract

ABSTRACT

We reviewed 58 literature reports of neonatal alloimmune thrombocytopenic purpura (NAITP). The mortality rate was 9%. The total incidence of suspected intracranial hemorrhage was 28%. We reviewed 17 sibship cases for the relation of birth order to treatment and outcome. Among firstborn affected infants (n = 17) the mortality rate and incidence of central nervous system sequelae were 24 and 47%, respectively, compared to rates of 5 and 15%, respectively, in their younger affected siblings (n = 20). The improved outcome in the latter group appeared to be related to more frequent cesarean section delivery and more frequent and earlier use of corticosteroids and maternal platelet transfusions in the neonate. Sensitive assays of maternal platelet alloantibody are now available, but they lack specificity for NAITP affecting the current gestation. There are two reports in which sensitive assays revealed risingtiters of maternal platelet alloantibody during advancing gestation. We propose further study to determine if this is specific for the antepartum diagnosis of NAITP.

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